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Black WR, Borner KB, Beauchamp MT, Davis AM, Dreyer Gillette ML, Sweeney B, Hampl SE. Health-Related Quality of Life across Recent Pediatric Obesity Classification Recommendations. Children (Basel) 2021; 8:303. [PMID: 33921016 PMCID: PMC8071434 DOI: 10.3390/children8040303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/22/2021] [Accepted: 04/07/2021] [Indexed: 11/24/2022]
Abstract
Extreme body mass index (BMI) values (i.e., above the 97th and below the 3rd percentiles) are inaccurately represented on the Centers for Disease Control and Prevention's growth curves, which may limit the utility of BMI percentile and BMI z-score for capturing changes in clinical outcomes for patients at extreme weights. Modeling child obesity severity based upon the percentage of BMI in excess of the 95th percentile (BMI95pct) has been proposed as an improved metric to better capture variability in weight at extreme ends of growth curves, which may improve our understanding of relationships between weight status and changes in clinical outcomes. However, few studies have evaluated whether the use of BMI95pct would refine our understanding of differences in clinical psychosocial constructs compared to previous methods for categorization. This cross-sectional study evaluated child obesity severity based on BMI95pct to examine potential group differences in a validated, obesity-specific measure of Health-Related Quality of Life (HRQoL). Four hundred and sixty-five children with obesity completed Sizing Me Up, a self-report measure of HRQoL. Children were classified into categories based on BMI95pct (i.e., class I: ≥100% and <120%; class II: ≥120% and <140%; class III: ≥140%). The results indicate that children with class III obesity reported lower HRQoL than children with class I and class II obesity; however, there were no differences between Class II and Class I. In much of the previous literature, children with class II and class III obesity are often combined under the category "Severe Obesity" based upon BMI above the 99th percentile. This study suggests that grouping children from various classes together would neglect to capture critical differences in HRQoL. Future research including children with severe obesity should consider obesity classes to best account for functioning and clinical outcomes.
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Affiliation(s)
- William R. Black
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO 64108, USA; (A.M.D.); (M.L.D.G.); (B.S.); (S.E.H.)
- Department of Pediatrics, The University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Kelsey B. Borner
- Department of Psychology and Behavioral Health, Children’s National Hospital, Washington, DC 20010, USA;
| | - Marshall T. Beauchamp
- Department of Psychology, University of Missouri–Kansas City, Kansas City, MO 6110, USA;
| | - Ann M. Davis
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO 64108, USA; (A.M.D.); (M.L.D.G.); (B.S.); (S.E.H.)
- Department of Pediatrics, The University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Meredith L. Dreyer Gillette
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO 64108, USA; (A.M.D.); (M.L.D.G.); (B.S.); (S.E.H.)
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO 64108, USA
| | - Brooke Sweeney
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO 64108, USA; (A.M.D.); (M.L.D.G.); (B.S.); (S.E.H.)
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO 64108, USA
| | - Sarah E. Hampl
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO 64108, USA; (A.M.D.); (M.L.D.G.); (B.S.); (S.E.H.)
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO 64108, USA
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Amaro CM, Mitchell TB, Cordts KMP, Borner KB, Frazer AL, Garcia AM, Roberts MC. Clarifying supervision expectations: Construction of a clinical supervision contract as a didactic exercise for advanced graduate students. Training and Education in Professional Psychology 2020. [DOI: 10.1037/tep0000273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Borner KB, Mitchell TB, Gray JS, Davis AM, Pont SJ, Sweeney BR, Hampl S, Dreyer Gillette ML. Factor Structure of a Spanish Translation of an Obesity-Specific Parent-Report Measure of Health-Related Quality of Life. J Pediatr Psychol 2018; 43:1028-1037. [PMID: 29771361 DOI: 10.1093/jpepsy/jsy030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 04/17/2018] [Indexed: 11/12/2022] Open
Abstract
Objective Latino youth are disproportionately affected by pediatric obesity and consequently experience impaired health-related quality of life (HRQOL). Although many caregivers of Latino youth do not speak English fluently, no validated Spanish translations of obesity-specific HRQOL measures exist for this population. Therefore, non-English-speaking Latino parents have typically been excluded from analyses related to HRQOL. This study assesses the factor structure of a Spanish translation of a parent-report measure of obesity-specific HRQOL, Sizing Them Up, in a treatment-seeking sample of children with obesity. Methods Structural equation modeling was used to assess the factor structure of the 6-subscale, 22-item Sizing Them Up measure in 154 parents of treatment-seeking Latino youth (5-18 years of age). Analyses exploring internal consistency and convergent validity were also conducted. Results Acceptable measurement fit was achieved for the six-factor solution. However, the higher-order model assessing Total HRQOL did not reach acceptable levels, as results found that the Positive Social Attributes (PSA) subscale was not representative of Total HRQOL; internal consistency and convergent validity results also supported this finding. Conclusions The current study provides support for the utility of a modified version of Sizing Them Up, excluding the PSA Scale, as a parent-report measure of obesity-specific HRQOL in treatment-seeking Latino youth with obesity.
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Affiliation(s)
- Kelsey B Borner
- Division of Pain Medicine, Children's National Medical Center
| | | | - Jane S Gray
- Texas Child Study Center, Dell Children's Medical Center, University of Texas at Austin
| | - Ann M Davis
- Center for Children's Healthy Lifestyles & Nutrition.,University of Kansas Medical Center
| | - Stephen J Pont
- Texas Department of State Health Services, Office of Science and Population Health.,University of Texas at Austin, Dell Medical School & College of Communications
| | - Brooke R Sweeney
- Center for Children's Healthy Lifestyles & Nutrition.,Department of Pediatrics, Division of General Academic Pediatrics, Children's Mercy Kansas City.,University of Missouri Kansas City School of Medicine
| | - Sarah Hampl
- Center for Children's Healthy Lifestyles & Nutrition.,Department of Pediatrics, Division of General Academic Pediatrics, Children's Mercy Kansas City
| | - Meredith L Dreyer Gillette
- Center for Children's Healthy Lifestyles & Nutrition.,Department of Pediatrics, Division of Developmental and Behavioral Sciences, Children's Mercy Kansas City
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Borner KB, Mitchell TB, Carlson JA, Kerr J, Saelens BE, Schipperijn J, Frank LD, Conway TL, Glanz K, Chapman JE, Cain KL, Sallis JF. Latent profile analysis of young adolescents' physical activity across locations on schooldays. J Transp Health 2018; 10:304-314. [PMID: 30555787 PMCID: PMC6289522 DOI: 10.1016/j.jth.2018.05.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE To investigate whether adolescents cluster into profiles based on where they accumulate moderate-to-vigorous physical activity (MVPA), if overall MVPA differs across profiles, and if walking to school and participant and neighborhood characteristics explain profile membership. METHODS Adolescents (N=528; mean age=14.12±1.44; 50% girls) wore accelerometers and Global Positioning Systems (GPS) trackers for 3.9±1.5 days to assess MVPA minutes in five locations: at home, at school, in home neighborhood, in school neighborhood, and other. Walking to school and participant characteristics were assessed by questionnaire, and neighborhood environment by Geographic Information Systems (GIS). Latent profile analysis (LPA) was used to identify profiles/groups of participants based on accumulation of physical activity across the five locations. Mixed-effects regression tested differences in overall MVPA, walking to school, and other characteristics across profiles. RESULTS Four initial profiles emerged: one Insufficiently Active profile and three "Active" profiles (Active Around School, Active Home Neighborhood, and Active Other Locations). The Insufficiently Active profile emerging from the first LPA (90% of participants) was further separated into four profiles in a second LPA: Insufficiently Active, and three additional "Active" profiles (Moderately-Active Around School, Moderately-Active Home Neighborhood, and Active At Home). Those in the six Active profiles had more overall MVPA (41.1-92.7 minutes/day) than those in the two Insufficiently Active profiles (34.5-38.3 minutes/day). Variables that differed across profiles included walking to school, sports/athletic ability, and neighborhood walkability. CONCLUSIONS Although most participants did not meet the MVPA guideline, the six Active profiles showed the places in which many adolescents were able to achieve the 60-minute/day guideline. The home and school neighborhood (partly through walking to school), "other" locations, and to a lesser extent the home, appeared to be key sources for physical activity that distinguished active from insufficiently active adolescents. Finding the right match between the individual and physical activity source/location may be a promising strategy for increasing active travel and MVPA in adolescents.
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Affiliation(s)
| | | | | | - Jacqueline Kerr
- University of California San Diego, La Jolla, California USA
| | - Brian E. Saelens
- Seattle Children’s Research Institute and the University of Washington, Seattle, Washington USA
| | | | | | - Terry L. Conway
- University of California San Diego, La Jolla, California USA
| | - Karen Glanz
- University of Pennsylvania, Philadelphia, Pennsylvania USA
| | | | - Kelli L. Cain
- University of California San Diego, La Jolla, California USA
| | - James F. Sallis
- University of California San Diego, La Jolla, California USA
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Tripicchio GL, Borner KB, Odar Stough C, Poppert Cordts K, Dreyer Gillette M, Davis AM. Confirmatory Factor Analysis of Sizing Me Up: Validation of an Obesity-Specific Health-Related Quality of Life Measure in Latino Youth. J Pediatr Psychol 2017; 42:457-465. [PMID: 28008005 DOI: 10.1093/jpepsy/jsw094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 10/23/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives This study aims to validate an obesity-specific health-related quality of life (HRQOL) measure, Sizing Me Up (SMU), in treatment-seeking Latino youth. Pediatric obesity has been associated with reduced HRQOL; therefore, valid measures are important for use in diverse populations that may be at increased risk for obesity and related comorbidities. Methods Structural equation modeling tested the fit of the 5-subscale, 22-item SMU measure in Latino youth, 5-13 years of age, with obesity ( N = 204). Invariance testing was conducted to examine equivalence between Latino and non-Latino groups ( N = 250). Results SMU achieved acceptable fit in a Latino population [χ 2 = 428.33, df = 199, p < .001, Root Mean Squared Error of Approximation = 0.072 (0.062-0.082), Comparative Fit Index = 0.915, Tucker-Lewis Index = 0.901, Weighted Root Mean Square Residual = 1.2230]. Additionally, factor structure and factor loadings were invariant across Latino and non-Latino groups, but thresholds were not invariant. Conclusions SMU is a valid measure of obesity-specific HRQOL in treatment-seeking Latino youth with obesity.
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Affiliation(s)
- Gina L Tripicchio
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | | | - Cathleen Odar Stough
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | | | - Meredith Dreyer Gillette
- Center for Children's Healthy Lifestlyes & Nutrition.,Developmental and Behavioral Sciences, Children's Mercy
| | - Ann M Davis
- Center for Children's Healthy Lifestlyes & Nutrition.,Department of Pediatrics, University of Kansas Medical Center
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Hampl SE, Borner KB, Dean KM, Papa AE, Cordts KP, Smith TR, Wade KR, Davis AM. Patient Attendance and Outcomes in a Structured Weight Management Program. J Pediatr 2016; 176:30-5. [PMID: 27289497 DOI: 10.1016/j.jpeds.2016.05.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/15/2016] [Accepted: 05/10/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To determine service utilization and identify patient characteristics associated with service utilization in youth with obesity presenting for structured weight management, and to explore weight-related outcomes associated with service utilization. STUDY DESIGN In this retrospective study conducted between January 2008 and December 2013, we examined variables associated with the care of 2089 patients aged 2-18 years presenting for an initial visit to 2 tertiary care-based, multidisciplinary structured weight management clinics. RESULTS Only 53% of patients returned for a second visit, 29% returned for a third visit, and virtually none (0.5%) completed the recommended 6 visits within 6 months. Patients who were Hispanic, government-insured, and whose parent/s spoke Spanish were more likely to return to clinic. Of those patients who returned for at least a second visit, 70% demonstrated a reduction in or maintenance of body mass index z-score. CONCLUSIONS Patient retention remains a significant barrier to effective pediatric weight management. Structured weight management programs should increase their efforts to engage patients and families at the initial visit and identify and address barriers to follow up.
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Affiliation(s)
- Sarah E Hampl
- Division of General Pediatrics, Children's Mercy Hospital, Kansas City, MO; Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO.
| | - Kelsey B Borner
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO; Clinical Child Psychology Program, University of Kansas, Lawrence, KS
| | - Kelsey M Dean
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO
| | - Amy E Papa
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO
| | | | - T Ryan Smith
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS
| | - Kerri R Wade
- Division of General Pediatrics, Children's Mercy Hospital, Kansas City, MO
| | - Ann M Davis
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO; Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS
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Borner KB, Canter KS, Lee RH, Davis AM, Hampl S, Chuang I. Making the Business Case for Coverage of Family-Based Behavioral Group Interventions for Pediatric Obesity. J Pediatr Psychol 2016; 41:867-78. [DOI: 10.1093/jpepsy/jsv166] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 12/08/2015] [Indexed: 01/18/2023] Open
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Poppert KM, Patton SR, Borner KB, Davis AM, Dreyer Gillette ML. Systematic review: mealtime behavior measures used in pediatric chronic illness populations. J Pediatr Psychol 2015; 40:475-86. [PMID: 25622593 PMCID: PMC6281003 DOI: 10.1093/jpepsy/jsu117] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 12/04/2014] [Accepted: 12/09/2014] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE This systematic review evaluates the utility and psychometric properties of pediatric mealtime assessments (direct observation and parent-report measures) using evidence-based criteria developed by the Division 54 Evidence-Based Assessment Task Force. METHOD Measures of mealtime behavior used in at least one chronic illness pediatric population were eligible for inclusion. A total of 23 assessment measures were reviewed (16 parent-/self-report; 7 direct observation). RESULTS 3 parent-report and 4 direct observation measures were classified as well-established, 3 met criteria for approaching well-established, and 13 were categorized as promising. Measures have been primarily used in children with feeding disorders, cystic fibrosis, and autism spectrum disorders. CONCLUSIONS Overall, the literature of pediatric mealtime assessment tools shows a strong evidence base for many direct observation methods and subjective parent-report measures. Exploratory and confirmatory factor analyses are available for some measures; recommendations for future validation research and measure development across pediatric populations are discussed.
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Affiliation(s)
- Katrina M Poppert
- Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
| | - Susana R Patton
- Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
| | - Kelsey B Borner
- Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
| | - Ann M Davis
- Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
| | - Meredith L Dreyer Gillette
- Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
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Van Allen J, Borner KB, Gayes LA, Steele RG. Weighing physical activity: the impact of a family-based group lifestyle intervention for pediatric obesity on participants' physical activity. J Pediatr Psychol 2014; 40:193-202. [PMID: 25241402 DOI: 10.1093/jpepsy/jsu077] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To examine differences in self-reported physical activity (PA) between participants enrolled in the treatment versus active control condition of a pediatric obesity intervention, and to test associations between parent and child PA. METHODS Participants (N = 93) included children aged 7-17 years and their parent. Analyses tested whether participants in the treatment condition reported greater PA at postintervention and 12-month follow-up compared with the control condition. Further, researchers examined change in PA across time and whether change in parent PA was associated with change in child PA. RESULTS Children in the treatment condition reported greater PA at 12-month follow-up. Parents in the treatment group reported a significant increase in PA between baseline and postintervention. Change in parent PA was associated with changes in child PA across multiple periods. CONCLUSIONS Family-based obesity interventions may promote long-term change in self-reported PA among youths, and change in parent PA may be a contributing factor.
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Affiliation(s)
- Jason Van Allen
- Clinical Psychology Program, Texas Tech University and Clinical Child Psychology Program, University of Kansas
| | - Kelsey B Borner
- Clinical Psychology Program, Texas Tech University and Clinical Child Psychology Program, University of Kansas
| | - Laurie A Gayes
- Clinical Psychology Program, Texas Tech University and Clinical Child Psychology Program, University of Kansas
| | - Ric G Steele
- Clinical Psychology Program, Texas Tech University and Clinical Child Psychology Program, University of Kansas
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